title: Pharmacokinetics of anidulafungin in two critically ill patients with septic shock undergoing CVVH.
abstract: Candidemia is associated with high mortality rate especially in critically ill (ICU) patients with septic shock and echinocandins such as anidulafungin are recommended as first-line treatment. Available pharmacokinetic studies of anidulafungin in healthy volunteers and in patients with renal or hepatic impairment showed that no dose adjustment is needed even in patients receiving standard intermittent haemodialysis. However, few data are available with continuous veno-venous haemofiltration (CVVH). In this study, the pharmacokinetic of anidulafungin was studied in two ICU patients with candidemia and septic shock undergoing CVVH. Both patients had satisfactory parameters of C(max) (9.04 and 5.68 mg/l, respectively), area under the curve (AUC) (95.18 and 67.48 mg/l h) and C(min) (2.61 and 1.43 mg/l). AUC/MIC ratio and C(max)/MIC values were: 11887 and 8435; 1130.25 and 710, for patients 1 and 2, respectively. Our data confirm that in patients with septic shock anidulafungin presents only mild pharmacokinetic changes compared to data reported during CVVH alone.
authors.forename: Francesco G
authors.initials: FG
authors.lastname: De Rosa
authors.forename: Silvia
authors.initials: S
authors.lastname: Corcione
authors.forename: Lorena
authors.initials: L
authors.lastname: Baietto
authors.forename: Daniela
authors.initials: D
authors.lastname: Pasero
authors.forename: Giovanni
authors.initials: G
authors.lastname: Di Perri
authors.forename: V Marco
authors.initials: VM
authors.lastname: Ranieri
authors.forename: Antonio
authors.initials: A
authors.lastname: D'Avolio
mesh_terms: D000368:Aged; D000077612:Anidulafungin; D000935:Antifungal Agents / Q000493:pharmacokinetics / Q000627:therapeutic use; D019540:Area Under Curve; D058387:Candidemia / Q000188:drug therapy; D016638:Critical Illness; D054714:Echinocandins / Q000493:pharmacokinetics* / Q000627:therapeutic use; D005260:Female; D006440:Hemofiltration / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D012772:Shock, Septic / Q000188:drug therapy*
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D000077612:Anidulafungin
keywords: Anidulafungin,; Continuous veno-venous haemofiltration,; Critically ill patients,; Dialysis; Pharmacokinetic,; Septic shock,